Any effort at comprehensive immigration reform must also address the health care needs of millions of immigrants with long-standing ties to this country. Absent such reform, immigrants needing ongoing medical care will remain vulnerable to the unethical practice of de facto deportation by hospitals, which is fueled by a lack of government reimbursement or oversight of international discharges.

In fact, a recent study from the Center for Social Justice and New York Lawyers for the Public Interest cites hundreds of cases of forced or coerced medical deportations. Acting alone or in concert with private transportation companies, as my colleagues and I report, hospitals are functioning as unauthorized immigration officers and engaging in de facto deportation of seriously ill or injured immigrant patients directly from their hospital beds to their native countries.

How often do doctors cause harm to their patients when they discharge them from the hospital? For a sizeable group of immigrant patients who are “discharged” to their countries of origin each year, the answer may be: more often than not. The story of Quelino Ojeda Jimenez, an immigrant from Oaxaca, Mexico, who became quadriplegic after a fall at his roofing job in Chicago, Illinois, is case in point.

A recentNew York Times article by John Leland recounted the lengthy medical history of Raymond Fok, an uninsured and undocumented immigrant who ended up marooned at New York City’s Downtown Hospital for 19 months after surviving a stroke. Although suffering from chronic health problems, including kidney failure, and initially in need of acute care, Mr. Fok remained in the hospital long after his initial emergency because he had no other place to go.

Without insurance or public benefits, numerous immigrants in the U.S. find similar fates in public hospitals, learning that without chronic or community-based services to assist them in recovery, they cannot be discharged. Rather than qualifying for a home health aide, or getting transferred to a nursing home, Mr. Fok’s status left him in the expensive care of an already cash-strapped public hospital. As Leland writes: “Mr. Fok’s immigration status never kept him from receiving treatment, but it helped make sure that his care would be delivered in the most expensive setting possible and in a place no one wants to spend more time than necessary.” Read more…

Over the past few years, stories have trickled into the U.S. national media about hospitals struggling to cope with the burden of caring for undocumented immigrants who lack insurance and are ineligible for benefits. These reports, including a recent series by New York Times reporter Kevin Sack and an even more recent NYT piece by Sam Roberts, feature accounts of chronically-ill patients being removed from dialysis, or ‘repatriated’ to their countries of origin in comas, to be cared for by long-lost and poorly-equipped relatives. As Luis Plascencia wrote on this blog a few years ago, these rare glimpses into hospital decision-making processes indicate that rising costs and non-existent legal protections for immigrants have led to a ‘privatization’ and ‘outsourcing’ of deportation by health care institutions.

To date, this meager public attention has focused exclusively on hospitals treating physical illnesses. Virtually no mention has been made of how psychiatric and mental health institutions handle undocumented immigrants. Read more…

Since at least 2001, an important phenomenon has emerged that has drawn some attention from the media but remains to be more fully examined by anthropologists and other social scientists: the actions of local private hospitals to remove/deport “undocumented” migrants from U.S. territory without interference from federal agencies. These actions appear to have involved primarily migrants from Central American and Mexico.

The passive role adopted by the Bush administration and now the Obama administration, and the generally unpublicized efforts by hospitals involved, mean that an unknown number of migrants have been involuntarily and “voluntarily” deported/removed despite the accepted principle of Federal preemption in the regulation of migration.

About ACCESS DENIED

Do unauthorized im/migrants have a right to health? To medical care? To publicly funded care? In this blog, medical anthropologists host a lively conversation among scholars, activists, policymakers and others on the complex and contentious issue of unauthorized migration and health. We approach the issue comparatively, with attention to power, cultural context, and historical depth. Through empirically grounded, critical dialogue, we aim to rethink current debates and inform policy about unauthorized migration and the right to health care.

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